Daily Health Policy Report

Monday, May 6, 2013

Last updated: Mon, May 6

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch

Medicare

Coverage & Access

Health Care Marketplace

Public Health & Education

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

State Spending On Consumer Assistance Could Have 'Huge Impact' On Marketplace Enrollment

Kaiser Health News staff writer Phil Galewitz, working in collaboration with The Washington Post, reports: "Florida is on course to spend $6 million to reach out to nearly 4 million uninsured people and help them sign up for coverage in the federal health law's online marketplace this fall. Maryland will spend more than four times as much, or about $24.8 million, to help about 730,000 uninsured. The District of Columbia expects to spend about $9 million assisting 42,000 uninsured. The wide variation in spending to hire and train people to provide consumer assistance in the first year of the new marketplaces could have a major impact on how many people actually get coverage under Obamacare, experts say" (Galewitz, 5/5). Read the story.

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Florida Legislative Session Ends Without Deal On Medicaid Expansion

WFSU's Lynn Hatter, working in partnership with Kaiser Health News and NPR, reports: "The question of whether Florida would expand its Medicaid program to cover more low-income people has been answered, and it's a 'no' — at least for now. The state legislature closed its regular session Friday without reaching an agreement to expand access to the program under the Affordable Care Act. To be revived in the near term, Gov. Rick Scott would have to call a special session of the Legislature. There has been no indication that he is willing to do that – or that he is close to a deal with state House Republicans that would warrant such a session" (Hatter, 5/3). Read the story.

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Capsules: Call Centers For Health Law Marketplaces To Create 9K Jobs; Bloggers See Own Reflections In Oregon Medicaid Study

Now on Kaiser Health News' blog, Phil Galewitz reports on how health law insurance marketplaces could be job creators: "The federal health law derided as a 'job-killer' by critics will create an estimated 9,000 jobs in 14 states this summer to handle consumer inquiries about new online insurance marketplaces. The jobs are through Vangent, a General Dynamics subsidiary, which was awarded a $530 million one-year contract by the federal government to set up call centers to answer inquriers related to the insurance marketplaces in 34 states where they will be run in whole or part by the federal government" (Galewitz, 5/3).

Also on Capsules, Jordan Rau reports on how the Oregon Medicaid study played in the blogosphere: "This week’s study of Oregon Medicaid recipients has quickly become a Rorschach test for how partisans and health policy wonks view the health care law" (Rau, 5/3). Check out what else is on the blog.

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Political Cartoon: 'Without Anesthesia?'

Kaiser Health News provides a fresh take on health policy developments with 'Without Anesthesia?' By Chris Wildt.

Meanwhile, here is today's health policy haiku:

WEIGHING THE FUTURE OF HEALTH EXCHANGES

Health plan marketing
and consumer assistance
...
Will it be enough?
-Anonymous

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

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Health Reform

Health Exchange Marketing, Consumer Assistance Efforts Take Center Stage

News outlets report on the steps being taken by state and federal governments, as well as by insurers, to reach out to consumers about insurance options that will be available in the new online marketplaces.

Kaiser Health News: State Spending On Consumer Assistance Could Have 'Huge Impact' On Marketplace Enrollment
Florida is on course to spend $6 million to reach out to nearly 4 million uninsured people and help them sign up for coverage in the federal health law's online marketplace this fall. Maryland will spend more than four times as much, or about $24.8 million, to help about 730,000 uninsured. The District of Columbia expects to spend about $9 million assisting 42,000 uninsured. The wide variation in spending to hire and train people to provide consumer assistance in the first year of the new marketplaces could have a major impact on how many people actually get coverage under Obamacare, experts say (Galewitz, 5/5).

Politico: Holding Noses, Insurers Start Hawking Obamacare
The insurance industry may have a love-hate relationship with Obamacare — but a "train wreck" is definitely not good for the bottom line. So health insurers are planning campaigns for the summer and fall to persuade a skeptical public to sign up and get covered by the health reform law (Haberkorn, 5/5).

Reuters: Obamacare Is On The Horizon, But Will Enough People Sign Up
Healthcare reform should be the signature Democratic achievement of President Barack Obama's presidency. But with "Obamacare" five months from show time, Democrats are worried about whether enough Americans will sign up to make the sweeping healthcare overhaul a success -- and what failure might mean for Congress heading into the 2016 presidential race (Morgan, 5/5).

CQ HealthBeat: Wooing The Young To Buy Coverage May Be A Last-Minute, Low-Key Sales Job
Will they or won't they? And what will it take to persuade them? "They" are the young, uninsured Americans the Obama administration is counting on to make the health care law work by signing up for coverage in the exchanges. If they do, the premiums they pay will offset the costs of older, sicker Americans and keep coverage in the new marketplaces affordable (Reichard, 5/3).

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Fla. Legislature Adjourns Without Medicaid Expansion Deal

Also in the news, the Arkansas model for expansion appears likely to win approval from the Obama administration.

The Washington Post: Florida Rejects Medicaid Expansion, Leaves 1 Million Uninsured
It seemed like a watershed moment for the Affordable Care Act when Florida Gov. Rick Scott (R), a staunch Obamacare opponent, embraced the Medicaid expansion in February. ... Scott wouldn’t be the one to "deny Floridians" a part of the health care law—but the Florida legislature had other plans. Lawmakers adjourned Friday after passing a budget that does not include funding for a Medicaid expansion. Unless the Republican-controlled legislature comes back for a special session later this year—which some Democrats are calling for—Florida will not expand Medicaid in 2014 (Kliff, 5/5).

The Associated Press/Washington Post: Florida Legislature Adjourns Without Passing Medicaid Expansion, Leaving 1.1 Million Uninsured
Florida Democratic leaders want Republican Gov. Rick Scott to veto the state budget or call a special session after the Legislature adjourned without passing an expansion of the state’s Medicaid program. House Democratic Leader Perry Thurston said some low-income Floridians are not benefiting from the budget (5/3).

Tampa Bay Times: Legislature's Inaction On Medicaid Reform Comes At A Price
Republican lawmakers say they are champions for Florida's businesses. But their failure to expand health insurance coverage to 1 million or more Floridians will put many employers in a financial lurch. Without a deal on health care, business owners across the state face the predicament of either paying to provide health insurance for their employees or facing federal government fines. Either way, the Legislature's inaction will saddle many businesses with additional costs that could reach, in total, close to $150 million next year (Mitchell, 5/4).

Kaiser Health News: Florida Legislative Session Ends Without Deal On Medicaid Expansion
The question of whether Florida would expand its Medicaid program to cover more low-income people has been answered, and it's a 'no' — at least for now. The state Legislature closed its regular session Friday without reaching an agreement to expand access to the program under the Affordable Care Act. To be revived in the near term, Gov. Rick Scott would have to call a special session of the Legislature. There has been no indication that he is willing to do that – or that he is close to a deal with state House Republicans that would warrant such a session (Hatter, 5/3).

Stateline: Obama Administration Poised To Approve Arkansas-Style Medicaid Expansions
The Obama administration appears ready to allow Arkansas — and a handful of other states — to pursue a market-based approach to fund health care for the poor in place of conventional Medicaid expansion under the new federal health care law. An announcement from the U.S. Dept. of Health and Human Services spells out exactly what states need to do to qualify. Called "premium assistance," the alternative plan would allow states to use federal Medicaid money to buy private insurance for low-income people from new state or federal health insurance exchanges created under the Affordable Care Act (Vestal, 5/6).

Meanwhile, progress reports from California, West Virginia and Minnesota -

The Associated Press: Brown, Democrats Wrangle Over Medicaid Expansion
California was an early booster of President Barack Obama's health care reform law and was the first state to authorize a health insurance exchange in 2010. It also was quick to commit to the optional Medicaid expansion that has been rejected by some Republican states. Turns out, saying yes was the easy part (5/6).

The Associated Press: Long, Vexing Process Led To WVa Medicaid Decision
Gov. Earl Ray Tomblin's decision to open Medicaid to more low-income West Virginians was reached neither quickly nor easily, administration officials say. The path to last week's announcement began in June, when the U.S. Supreme Court upheld the federal health care law. The ruling struck down language that threatened existing federal Medicaid funding for states that didn't expand their programs as called for by the sweeping overhaul (5/6).

MPR News: Health Care Overhaul Costs To Counties Offset By Federal Aid
Minnesota counties worried that the federal health care overhaul will bust their budgets are set to get millions of dollars in additional federal funding. The State Department of Human Services estimates the federal government will make available between $13 and $14 million a year for Minnesota counties to carry out the anticipated increase in people enrolling in Medicaid under the health care law (Stawicki, 5/5).

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Employers Seek To Avoid Health Insurance Mandate

The Wall Street Journal reports that some employers are pushing back against the requirement that companies must provide insurance to employees who work 30 hours a week or more. Also in the news, the Associated Press reports on states' concerns about cost-shifting in plans for people with medical problems, and The Hill details activists' fears that the health law could become a tool for deporting workers who are in the country illegally.

The Wall Street Journal: Employers Push Back On Health Law's Insurance Trigger
Employers are putting increasing pressure on lawmakers to peel back a piece of the federal health-care law that requires firms provide insurance to employees working 30 hours a week or more. But such a change faces long odds on happening with only months before the requirement begins. Meanwhile, employers including cities, state agencies and charities have joined restaurants and retailers in paring workers' hours to avoid having to provide these workers insurance or pay a fee starting next year (Radnofsky, 5/3).

The Associated Press: States Fear Costs Could Shift As Feds Move To Cap Spending On Health Overhaul Program
Thousands of people with serious medical problems are in danger of losing coverage under President Barack Obama's health care overhaul because of cost overruns, state officials say. At risk is the Pre-Existing Condition Insurance Plan, a transition program that's become a lifeline for the so-called uninsurables — people with serious medical conditions who can't get coverage elsewhere. The program helps bridge the gap for those patients until next year, when under the new law insurance companies will be required to accept people regardless of their medical problems (Alonso-Zaldivar, 5/4).

The Hill: Farm Workers: Don't Use ObamaCare To Deport People
A group representing farm workers is urging the Obama administration not to use the new healthcare law as a tool to deport people. The organization, Farmworker Justice, wrote on Thursday to the IRS -- the agency tasked with carrying out the applications for exemption to the health law's individual mandate -- for assurances the ObamaCare application will not be used for alternative purposes (Wilson, 5/5).

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Do Children's Health Concerns Fall Through The Health Law's Cracks?

MedPage Today takes a long look at how the health law impacts children's health programs.

MedPage Today: CHIP Faces Uncertain Future
The final implementation of the Affordable Care Act (ACA) could be bad news for re-authorization of the Children's Health Insurance Program (CHIP), a congressional staffer said. … Authorization for the program, which provides health coverage to families who make too much to qualify for Medicaid but too little to afford costly health insurance, expires at the end of September 2013. But it remains to be seen how CHIP will work with the ACA. President Obama's 2010 health law sought to expand Medicaid coverage for those living up to 133 percent of poverty, while providing tax credits for those who don't [qualify] for expanded Medicaid and make up to 400 percent of poverty. ... CHIP won't completely disappear after its current 4-year authorization ends on September 30. Instead, the program will just revert back to previous year's funding levels and lawmakers will have an opportunity to wait for the ACA to fully come online and reassess the program (Pittman, 5/5).

Medpage Today: Policymakers Fail To Address Kids' Health
Public policy and research has largely ignored the health needs of children lately and it's a practice that will end up backfiring years from now, pediatricians said here. Health policy has turned into cost containment policy, which disproportionately favors Medicare and "children's issues get marginalized almost by definition," Paul Wise, MD, MPH, from Stanford University in Stanford, Calif., said at the Pediatric Academic Societies annual meeting. As a result, policymakers "neglect" the medical care of children and focus on their social and welfare issues, Wise said. He said forgetting about those with special health needs today may undermine those cost-containment efforts and advances in pediatric care in the future (Pittman, 5/4).

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Capitol Hill Watch

GOP Leaders Poised To Exploit Health Law Problems

The AP reports that House Budget Committee Chairman Paul Ryan, R-Wis., says Republicans must be ready to offer voters frustrated with the health law's implementation a better alternative, while House Majority Leader Eric Cantor, R-Va., plans another vote on the health law's repeal.

The Associated Press: Ryan Tells GOP To Capitalize On Health Care
U.S. Rep. Paul Ryan told Wisconsin Republicans at the state party convention Saturday that they must capitalize politically on the implementation of President Barack Obama’s health care overhaul, offering those who become frustrated a better alternative. Ryan said as the law goes into effect, health insurance costs for individuals and businesses will skyrocket, employers will drop coverage for workers and Republicans need to be there to attract those angry about it (Bauer, 5/6).

Politico: Eric Cantor Pledges Another Obamacare Repeal Vote
The House will vote again in the "near future" on full repeal of Obamacare, House Majority Leader Eric Cantor said in a memo to fellow Republicans Friday. He said a timeline has not yet been set (Haberkorn, 5/3).

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Medicare

White House Medicare Proposal Draws Ire From Advocates, Liberals

The Hill reports that President Barack Obama's plan to combine Medicare's doctor and hospital costs is unpopular among advocates for the elderly and some liberal Democrats. Meanwhile, Medpage Today details how the creation of the health law's Independent Payment Advisory Board is on hold because of the slow growth of Medicare spending. The board is supposed to be a backstop if Medicare spending tops a target growth rate.

The Hill: Left Boils As Obama Floats Major Change To Medicare Part A And B
The left is lashing out at a proposal to reform Medicare that President Obama said he would consider as a way to reduce the deficit. Left-leaning groups and liberal lawmakers say that combining Medicare's doctor and hospital coverage would saddle beneficiaries with higher costs (Viebeck, 5/4).

Medpage Today: Medicare: Cost-Cutters On Hold
A Medicare cost-cutting board created by the Affordable Care Act (ACA) -- the subject of much criticism from the medical community and supporters of the law as a whole -- won't have an impact on the program until at least 2016, a top Medicare official said this week. The Independent Payment Advisory Board (IPAB) was to form later this year or early next to recommend ways to scale back Medicare spending beginning in 2015. However, the trigger for its formation -- the growth of Medicare spending topping the growth of overall inflation and inflation on medical goods and services -- failed to hit that target, Paul Spitalnic, acting chief actuary for the Centers for Medicare and Medicaid Services (CMS), wrote in a letter dated Tuesday (Pittman, 5/3).

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Coverage & Access

Caregivers Juggle Medical Tasks

Boston Globe: Caregivers Taking On More Complex Medical Tasks
Just listening to Irene Ingemi describe the patchwork system of friends, family, and part-time day-care services she’s stitched together to help her care for her frail mother-in-law is exhausting. The 90-year-old broke her hip last fall and has since become incontinent, needs a walker to get around, takes seven pills daily, and is having increasing memory problems. As Ingemi, a 60-year-old nursery school teacher, dashes from work back to her Norwood home each day, she mentally juggles a list of appointments for her mother-in-law with chores that need to get done (Lazar, 5/6).

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Health Care Marketplace

The Race To Make Abuse-Proof Painkillers; States Lead On Compounding Pharmacy Regulation

Developments in pharmaceuticals make headlines: the race to make painkillers that are difficult to abuse, state action on regulating compounding pharmacies and the difference in how much different Americans pay for prescriptions.

The Wall Street Journal: Unmeltable, Uncrushable: The Holy Grail In Painkillers
The arms race to build a safer painkiller is under way. In the wake of a key decision by the Food and Drug Administration, more than a dozen pharmaceutical companies -- from startups to Pfizer Inc. -- are vying to create painkilling drugs that are difficult to abuse (Martin and Rockoff, 5/5).

Politico: States Take Lead On Compounding Pharmacies
Several states are taking matters into their own hands to boost oversight of large-scale pharmacies like the one behind the deadly fungal meningitis outbreak last fall as the outlook for congressional action is somewhat murky. So far, 15 states have taken up bills to step up the regulation of facilities like the one linked to the outbreak. Five have passed them into law, nine are still weighing their options, and only Mississippi has rejected the effort, according to the National Conference of State Legislatures (Norman, 5/6).

Marketplace: Map: You May Be Paying Way More For Birth Control
Do you shop around when it comes to paying for your prescription drugs? A new study from Consumer Reports shows that it pays off. Americans spent on average $758 out of pocket for medication in 2012, according to the study. And when secret shoppers called more than 200 pharmacies around the United States to get prices for a month's supply of five top-selling prescription drugs that recently became available at generic, they found whopping difference of $749 between the highest- and lowest-priced stores. Takeaway? Shop around. When it comes to birth control, the same school of thought applies (Paranada, 5/3).

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Public Health & Education

Health Providers With Hepatitis B Are Covered By Disability Law

The Associated Press/Washington Post: Feds: Health Providers With Hepatitis B Are No Threat To Patients, Covered By Disability Law
The U.S. Department of Justice recently declared in a legal settlement that hepatitis B patients are protected by federal disability law. And, separately, federal health officials have issued a revised set of guidelines that make it clear that health care workers and students who carry the hepatitis B virus — HBV for short — generally pose little or no risk to patients. Taken together, advocates say, the new health guidelines and the Justice Department settlement remove barriers to practice, handing HBV-positive health professionals and students a pair of powerful tools to combat discrimination (5/5).

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State Watch

State Roundup: Brighter Calif. Budget Outlook Could Mean New Safety Net Cut Fights

A selection of health policy stories from Texas, California and Oregon.

The Texas Tribune: Divided Lege Finds Rate Harmony In Women's Health 
The political fireworks and high-octane drama that accompanied lawmakers’ 2011 fight over women’s health care and abortion has been absent this legislative session. It has been replaced with some semblance of concession, as legislators on both sides of the aisle work quietly to restore financing for women’s health services. They have done it with little more than a handshake agreement. Democrats will not die on the sword of bringing Planned Parenthood back into the fold, and Republicans will not put up additional barriers to women’s access to care (Aaronson, 5/6).

Sacramento Bee: With Revenue Rising, Democrats Push To Restore Safety Net Cuts
Gov. Jerry Brown and Democratic lawmakers are on a collision course over restoring cuts to California's safety net, marking a key test of vows to hold the line on state spending. Brown is set to release a revised budget proposal this month, and state revenue is running about $4.5 billion over projections, lending momentum to efforts to boost programs for the poor or needy. Legislation and ideas abound at the Capitol for bolstering the safety net, targeting adult dental care, mental health, welfare assistance, child care, college aid and affordable housing (Sanders, 5/6). 

California Healthline: Managed Care Tax Decision Left Until New Budget Proposal Arrives
Distrust ran high yesterday during part of a budget subcommittee hearing when the subject turned to reinstitution of a managed care organization tax. The MCO tax instituted in 2009 had the singular distinction of being embraced by the ones being taxed because the money was matched by federal dollars and was used to support the Healthy Families program. In the long run, health insurers made their money back and the state had more federal dollars in its coffers. The MCO tax expired in December. The Brown administration wants to keep it going with one big difference: Since the state eliminated Healthy Families, a transition that started in January and runs through the end of this year, the governor would like to put the MCO tax money into a rainy-day fund for the state (Gorn, 5/3).

Los Angeles Times: White Memorial Medical Center In L.A. Settles Kickback Allegations
White Memorial Medical Center in Los Angeles has agreed to pay $14.1 million to settle allegations that it paid illegal kickbacks to physicians to get their patient referrals. The settlement announced Friday by the U.S. Justice Department stemmed from a whistle-blower complaint filed under seal in 2008 by two Los Angeles doctors who objected to the hospital's practices (Terhune, 5/4).

Oregonian: Lack Of Standards For Oregon Medical Interpreters Raises Issues About Training
Doctors who don't understand the language of their patients rely on interpreters to explain everything from a diagnosis to prescription routines. And although Oregon is one of only a handful of states with qualification and certification exams for medical interpreters, the vast majority of interpreters working in the state have neither and don't have to. The state recognizes three tiers of medical interpreters: registered (the basic level), qualified (tested in the language) and certified (tested in medical terminology) (Castillo, 5/5).

KQED/State Of Health: How Nurses And Other 'Mid-Level Providers' Fill Growing Gap In Primary Care
Simmi Gandhi -- a family nurse practitioner at South LA's UMMA Community Clinic -- is at work early. When she calls a patient, she apologizes for waking the woman up. But she knew the woman was waiting for test results. In Urdu, she tells the patient her mammogram shows the mass in the woman's breast isn't cancer. After Gandhi hangs up, she doesn't miss a beat: She starts debriefing for her next patient, who's been missing appointment for months (Martinez, 5/3).

Los Angeles Times: How A 'Million-Dollar Patient' Got Off A Medical Merry-Go-Round
Remo and countless other chronically ill patients like her pose one of the biggest obstacles to medical professionals, hospitals and political leaders trying to rein in costs as they overhaul the healthcare system. Starting next year, clinics in rural and urban areas will receive an influx of millions of newly insured patients — many with complex, chronic diseases — and face higher expectations to keep costs down. Many of those patients are so ill — or resistant to altering behaviors — that they repeatedly cycle through expensive emergency rooms and hospital beds (Gorman, 5/5).

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Editorials and Opinions

Viewpoints: Assessing The Oregon Medicaid Experiment; Health Insurance Hysteria; In Florida, 'Toxic Politics' Beats Out Common Sense

The Washington Post: Here's What The Oregon Medicaid Study Really Said
So here's what happened in the first two years of the Oregon Medicaid experiment: Medicaid proved itself good health insurance. The people who got Medicaid used more health care, and seem to have done so smartly — they got preventive care, they got their diabetes diagnosed and began managing it, they treated their depression, and so on. But the health care itself didn't work as well as we hoped — at least not in terms of cutting rates of hypertension and cholesterol (Ezra Klein, 5/2).

The New York Times: What Health Insurance Doesn't Do
As liberals have been extremely quick to point out, these findings do not necessarily make a case against the new health care law, which includes a big Medicaid expansion as well as subsidies for private insurance. After all, the first purpose of insurance is economic protection, and the Oregon data shows that expanding coverage does indeed protect people from ruinous medical expenses. The links between insurance, medicine and health may be impressively mysterious, but staving off medical bankruptcies among low-income Americans is not a small policy achievement. This is true. But it's also true that the health care law was sold, in part, with the promise (made by judicious wonks as well as overreaching politicians) that it would save tens of thousands of American lives each year (Ross Douthat, 5/4).

Bloomberg: Yes, The Oregon Health Study Matters
But the lesson of the Oregon Health Study is nonetheless that there’s cost-effectiveness information out there that Medicaid and other health insurers aren’t exploiting. And even though conservatives have generally done a terrible job of explaining why, conservative ideas about increasing consumer direction in health care could help to exploit that information and make health care more cost-effective -- without repealing Obamacare or stopping the Medicaid expansion (Josh Barro, 5/3).

The Wall Street Journal: An ObamaCare Penalty On Hospitals
Under the Affordable Care Act's Hospital Readmissions Reduction Program, hospitals that readmit "excessive" numbers of Medicare patients within 30 days of discharge now face significant penalties. The maximum penalty is 1% of a hospital's Medicare reimbursement, but that will increase to 3% in 2015. That may not sound like a lot, but for hospitals already struggling financially—especially those serving the poor—losing 1%-3% of their Medicare reimbursements could put them out of business (Stephen Soumerai and Ross Koppel, 5/5). 

Bloomberg: Beware Of Hysteria Over New Health Insurance Rates
Last month, Maryland made public the premiums that health insurers want to charge next year under the Affordable Care Act, one of the first states to do so. Premiums for non-employer health-insurance coverage were eye-popping, with a proposed average increase of 25 percent. As insurers submit their proposals in every state this spring, a pattern of such large premium increases may emerge. And opponents of the 2010 health-care law will pounce. But the news media and the public shouldn't succumb to their hysteria (Topher Spiro, 5/5).

The Wall Street Journal: A Jobs Fillip
One big negative in the April report is the increase in part-time employment. ... All of this suggests that ObamaCare is beginning to skew hiring patterns. Employers will soon have to offer health-insurance or pay a penalty for full-time workers, which the health law defines as anyone who works at least 30 hours a week. Many small businesses appear to be limiting their employees to fewer than 30 hours, perhaps with job-sharing or even by splitting employees with other employers (5/3). 

Miami Herald: On Medicaid, GOP Politics Trumps Common Sense
Surely the people of Florida had a right to expect that during the 60 days of the annual legislative session lawmakers would find a way to accept the federal government's offer of $51 billion over the next decade to expand Medicaid. And yet House Republicans, led by Speaker Will Weatherford, R-Wesley Chapel, failed to reach a workable compromise with their counterparts in the Republican-led Senate, effectively killing any deal for now and leaving Florida's uninsured in jeopardy. This is a huge loss for the people of Florida, the triumph of toxic politics over common sense (5/4).

Tampa Bay Times: The Legislature's $51 Billion Failure
They PURRED like cats, listened to an auto-reader named Mary speed-read bills and honored golfer Jack Nicklaus. They raised university tuition, outlawed Internet sweepstakes cafes and banned texting while driving. They gave state workers raises for the first time in seven years and spent millions on pet projects such as a rowing center in Sarasota, a Bay of Pigs museum in Miami and an aquarium in Clearwater. But state lawmakers refused to accept $51 billion in federal money to provide health care to 1 million uninsured Floridians, and that leaves a permanent stain on the 2013 Florida Legislature (5/3).

New Orleans Times Picayune: Expanding Medicaid Is Crucial For Louisiana Residents
Gov. Jindal argues that over a decade Louisiana might have to spend $1.7 billion on the expansion, that Medicaid is inefficient and that there are too many uncertainties. He also says that too many Louisianians would be dependent on the government for health care under the expansion. Frankly, none of that is persuasive (5/5).

Toledo Blade: Drop The Teacup, Lawmakers, And Expand Medicaid
The Republicans who control Ohio’s General Assembly are making an instructive choice. They are denying health insurance to hundreds of thousands of working-poor Ohioans — and defying the governor of their party — so they can pander to the hard-right bloc of GOP voters. These lawmakers are betting that they will be rewarded, not punished, at the polls next year for working against the best interests of the state and its taxpayers. And given the way Ohio rigs its legislative elections, that calculation may be smart politics, even though it's terrible public policy (David Kushma, 5/4).

Boston Globe: Health Insurance: A Painfully Long Wait
One million hours. That's how much time new Harvard research suggests psychiatrists spend each year obtaining insurance approval to hospitalize suicidal or mentally ill patients. That translates into time taken away from patient care but also, more importantly, means patients in crisis are stuck in emergency rooms for a median of 8.5 hours, more than twice the length for most other admissions. This bureaucratic roadblock needs to be streamlined (5/6)

The New York Times' Opinionator: How Colonoscopies Are Like Home Renovations
So what should contractors do? They could promptly repair every problem the moment a homeowner identifies it. But that would be costly and seems unlikely. Perhaps instead they should consider picking something the homeowner really cares about and exceeding expectations on that one repair — but only at the very, very end. One friend told me that her contractor gave her an espresso machine when the job was finished. Even if she ultimately paid for the gift, her memories of the experience were sweeter than mine. The good thing is that, like a colonoscopy, once the remodeling is over, you won't need another one for years (Ezekiel J. Emanuel, 5/6).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Ankita Rao
Marissa Evans

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2012 Kaiser Health News. All rights reserved.